Oncology Pretest

A nurse is caring for a client who just received the first cycle of chemotherapy for acute leukemia 2 days ago. The nurse, is closely monitoring the client's lab tests of uric acid, potassium, phosphorus, and calcium based on the knowledge that the client is at risk for A. Superior vena cava syndrome B. Spinal cord compression C. Septic shock D. Tumor lysis syndrome

D. Tumor lysis syndrome

When caring for a client with an internal radiation implant, the nurse should observe which principles? Select all that apply. 1. Allowing individuals younger than 16 years old in the room as long as they are 6 feet away from the client. 2. Placing the client in a private room with a private bath. 3. Wearing a lead shield when providing direct client care. 4. Keeping pregnant women out of the client's room. 5. Removing the dosimeter film badge when entering the client's

2. Placing the client in a private room with a private bath. 3. Wearing a lead shield when providing direct client care. 4. Keeping pregnant women out of the client's room.

A client is a 46 y/o businessman with a diagnosis of metastatic lung cancer, is going to have chemotherapy tomorrow. To help the client better understand the role of chemotherapeutic agents in treating cancer, a nurse has developed a teaching plan. The nurse determine the plan is effective when the client states A. "Chemotherapy is a preferred therapy because it has fewer adverse effects than radiation therapy" B. "Chemotherapy includes drugs that not only attack cancer cells, but also normal rapidly dividing cells" C. "Chemotherapy uses only a single drug to treat cancer because drug resistance is rare" D. "Chemotherapy uses drugs that promote normal growth of cells while killing the cancer cells"

B. "Chemotherapy includes drugs that not only attack cancer cells, but also normal rapidly dividing cells"

A nurse has received report on the following clients. Which client would the nurse see first? A. A 70 year old male with osteosarcoma and is scheduled for chemotherapy this morning B. A 65 year old female with ovarian cancer and radiation implant "fell out" C. A 45 year old female with metastatic lung cancer and an oxygen saturation of 89% D. A 52 year old male with wet desquamination and complaints of green drainage

B. A 65 year old female with ovarian cancer and radiation implant "fell out"

A client recieving chemotherapy is admitted with a vancomycin-resistant enterococcus (VRE) infection. Which action can be delegated to a nursing assistant who is assisting with the client's care? A. Monitor the results of ordered laboratory culture and sensitivity tests B. Teach the client and family members about means to prevent transmission of VRE C. Communicate with other departments when the client is transported for ordered tests D. Implement contact precautions when caring for the client

D. Implement contact precautions when caring for the client

A female client complains of nausea and vomiting following her daily chemotherapy treatment. The most appropriate nursing intervention would be to A. Keep the client NPO until her daily chemotherapy is completed. B. Schedule chemotherapy for bedtime C. Provide clear liquids until the chemotherapy is completed. D. Provide antiemetic medication 30 to 40 minutes before each treatment.

D. Provide antiemetic medication 30 to 40 minutes before each treatment.

A client with leukemia is receiving colony-stimulating factors (CSFs). The nurse anticipates that the client will be affected by the medication by exhibiting: A. a decrease in the actual size of the tumor. B. diminished bacterial infection. C. an increase in fungus-destroying ability. D. a decrease in length of posttreatment neutropenia.

D. a decrease in length of posttreatment neutropenia.

A 74-year-old client preparing to undergo a colon resection for cancer of the colon asks about the elevated carcinoembryonic antigen (CEA) test result. The nurse explains that the test is used to A. identify any metastasis of the cancer. B. confirm the diagnosis of a specific type of cancer. C. determine the need for postoperative chemotherapy. D. monitor the tumor status after surgery.

D. monitor the tumor status after surgery.

What can the nurse do to facilitate cancer prevention for the client n the promotion stage of cancer development? Select all that apply 1. Teach the client which vitamins will improve the immune system. 2. Teach the client to have the cancer surgically removed now. 3. Teach the client promoting factors to avoid. 4. Teach the client to exercise daily.

3. Teach the client promoting factors to avoid. Correct! 4. Teach the client to exercise daily.

A client is ordered cisplatin 3 mg/kg per day for 5 days. The client weighs 154 lbs. The pharmacy has supplied cisplatin 150 mg per 2mL. How many mL will the nurse administer? (Please round to the nearest tenth).

2.8 mL

A client is complaining of nausea post chemotherapy. The health care provider has ordered odansetron 4 mg intravenous continuously. The pharmacy has provided odansetron 100mg in 500 mL 0.9% saline. How many mL will the nurse set the intravenous pump at? (Please round the nearest whole number)

20 mL/hr

Which of the following should be included in the teaching plan for a cancer client who is experiencing thrombocytopenia? Select all that apply 1. Avoid aggressive flossing for oral care 2. Monitor temperature daily 3. Include an over the counter nonsteroidal anti-inflammatory (NSAID) daily for pain control 4.Report bleeding, such as nosebleed, petechiae, or melena, to a health care provider 5. Use a soft-bristle toothbrush 6. Use an electric razor

1. Avoid aggressive flossing for oral care 4.Report bleeding, such as nosebleed, petechiae, or melena, to a health care provider 5. Use a soft-bristle toothbrush 6. Use an electric razor

Tamoxifen citrate is prescribed for a client with metastatic breast carcinoma. The nurse administering the medication understands that which is the primary action of this medication? 1. It increases DNA and RNA synthesis. 2. It promotes the biosynthesis of nucleic acids. 3. It competitively binds to estrogen receptors on tumors and other tissue targets. 4. It increases testosterone concentration and testosterone response.

1. It increases DNA and RNA synthesis. 3. It competitively binds to estrogen receptors on tumors and other tissue targets.

A client with lung cancer is being cared for by his wife at home. His pain is increasing in severity. The nurse recognizes that teaching has been effective when the wife does which of the following? Select all that apply. 1. Avoids long acting opioids due to her concern about addiction 2. Has her husband use a pain rating scale to measure the effectiveness at reaching his individual pain goal 3. Uses music for distraction as well as heat or cold in combination with medications 4. Administers immediate release medication for breakthrough pain 5. Administers long -acting or sustained release oral pain formula (Oxycontin) regularly around the clock 6. Substitutes acetaminophen to avoid tolerance to the medications

2. Has her husband use a pain rating scale to measure the effectiveness at reaching his individual pain goal 3. Uses music for distraction as well as heat or cold in combination with medications 4. Administers immediate release medication for breakthrough pain 5. Administers long -acting or sustained release oral pain formula (Oxycontin) regularly around the clock

As part of chemotherapy education, the nurse teaches a female client about the risk for bleeding and self-care during the period of greatest bone marrow suppression (the nadir). The nurse understands that further teaching is needed if the client makes which statement? A. "I'm going to take aspirin for my headache as soon as I get home." B. "I may need a platelet transfusion if my platelet count is too low." C. I will count the number of pads and tampons I use when menstruating." D. "I should avoid blowing my nose."

A. "I'm going to take aspirin for my headache as soon as I get home."

A nurse receives report on the following clients. Which client would the nurse see first? A. A 55 year old client receiving a bone marrow transplant and a temperature of 38.9 (102.0). B. A 67 year old client receiving debulking procedure for colon cancer complaining of bloating. C. A 40 year old client receiving radiation treatments and complaints of itching at the site. D. A 35 year old client receiving chemotherapy and a white count of 4500 mm3.

A. A 55 year old client receiving a bone marrow transplant and a temperature of 38.9 (102.0).

A client is receiving external radiation for treatment of lung cancer. The nurse teaches the client that care of the skin in the marked area includes A. Cleanse the skin with plain water B. Apply antibiotic ointment daily C. Avoid contact with others D. Apply a dry sterile dressing to the treated skin areas

A. Cleanse the skin with plain water

A client is taking G-CSF, or filgrastim (Neupogen). Which nursing interventions are indicated for the most common side effect of this medication? A. Nonnarcotic analgesia and comfort measures for pain B. Stool softeners and a high-fiber diet for constipation C. High fluid intake and vitamin C for alkaline urine D. Aspirin and assessment for fever

A. Nonnarcotic analgesia and comfort measures for pain

A nurse is assessing a female who is receiving her second administration of chemotherapy for breast cancer. When obtaining this client's health history, what is the most important information the nurse should obtain? A. "Do you have your usual energy level?" B. "Have you had nausea or vomiting?" C. "Have you been sleeping at night?" D. "Has your hair been falling out in clumps?"

B. "Have you had nausea or vomiting?"

A client with leukemia is considering whether to have hematopoietic stem cell transplantation. Which information will be included in client teaching? A. Transplant of the donated cells is painful because of the nerves in the tissue lining the bone. B. Hospitalization will be required for several weeks after the hematopoietic stem cell transplant (HSCT). C. The transplant procedure takes place in a sterile operating room to minimize the risk for infection. D. Donor bone marrow cells are transplanted through an incision into the sternum or hip bone.

B. Hospitalization will be required for several weeks after the hematopoietic stem cell transplant (HSCT).

A client is admitted with tumor lysis syndrome. The nurse would anticipate which of the following orders? A. Potassium chloride 20 mEq over 2 hours B. Normal Saline infusion at 150 mL/hr C. Cefazolin 1 gram every 6 hours D. 2 units packed red blood cells

B. Normal Saline infusion at 150 mL/hr

When reviewing the chart for a client with cervical cancer, the nurse notes that the cancer is staged as Tis, N0, M0. The nurse will teach the client that A. further testing is needed to determine the spread of the cancer. B. the cancer is localized to the cervix. C. the cancer cells are well-differentiated. D. it is difficult to determine the original site of the cervical cancer.

B. the cancer is localized to the cervix.

A 36 y/o female is scheduled to receive external radiation and a cesium implant for cancer of the cervix. Which of the following would be the most accurate to include in the teaching plan about the potential side effects of radiation on sexuality? A. "You will continue to have normal menstrual periods during treatment" B. "You may notice some vaginal relaxation after treatment is completed" C. "You may notice some vaginal dryness after treatment is completed" D. "You can have sexual intercourse while the implant is in place"

C. "You may notice some vaginal dryness after treatment is completed"

A client recieving chemotherapy is admitted with a vancomycin-resistant enterococcus (VRE) infection. Which action can be delegated to a nursing assistant who is assisting with the client's care? A. Monitor the results of ordered laboratory culture and sensitivity tests B. Teach the client and family members about means to prevent transmission of VRE C. Implement contact precautions when caring for the client D. Communicate with other departments when the client is transported for ordered tests

C. Implement contact precautions when caring for the client

A nurse is teaching a client about chemotherapy. A nurse explains that the treatment is contraindicated to which of the following conditions/diseases? A. Wilm's Tumor B. Alopecia C. Pregnancy D. Ewing's sarcoma

C. Pregnancy

A client with leurkemia has neutropenia. Which assessment should a nurse complete frequently? A. Musculoskeletal B. Neurovascular C. Respiratory D. Integumentary

C. Respiratory

The most effective method of administering a chemotherapy agent that is a vesicant is to A. give it orally. B. use an Ommaya reservoir. C. deliver via central venous device D. administer it intraarterially.

C. deliver via central venous device

A 26-year-old client with a family history of stomach cancer asks the nurse about ways to decrease the risk for developing stomach cancer. The nurse will teach the client to avoid A. chronic use of H2 blocking medications. B. foods that cause distention or bloating. C. emotionally stressful situations. D. smoked foods such as ham and bacon.

D. smoked foods such as ham and bacon.

A client diagnosed with lung cancer reports he is having trouble sleeping and often feels tense. The most appropriate initial nursing intervention would be to A. Obtain an order for medication for sleep from the health care provider. B. Document the client's report of difficulty sleeping and tenseness in the chart. C. Offer an antianxiety drug such as Ativan D. Encourage the client to express his feelings about the cancer diagnosis.

D. Encourage the client to express his feelings about the cancer diagnosis.

A 56-y/o female is currently receiving radiation therapy to the chest wall for recurring breast cancer. She has pain while swallowing and burning and tightness in her chest. The nurse should further assess the client for indications of A. Stomatitis B. Hiatal hernia C. Radiation enteritis D. Esophagitis

D. Esophagitis

A client experiences bone marrow depression as a result of chemotherapy. Which of the following would the nurse expect to find? A. Nausea and vomiting B. Alopecia C. Temperature of 102.6 F D. Platelet count 50,000

D. Platelet count 50,000

The client has for breakfast 8 ounces of coffee, 4 ounces orange juice 6 ounces of milk on Raisin Bran, toast and eggs. For lunch the client has cheeseburger 12 ounces cola and 3 ounces of ice cream. What is the total intake a nurse would document?

990 mL

A client is ordered 2L 0.9% saline over 4 hours as a premedication for cyclophosphamide. How many mL per hour will the nurse set the pump at? (Please round to the nearest whole number.)

300 mL/hr

A client is ordered 2 gm. methotrexate. The pharmacy has provided methotrexate 500 mg scored tablets. The nurse would correctly administer how many tablets?

4 tablets

A client is to receive oprelvekin. The nurse confirms that the client is experiencing fluid retention related to the medication by monitoring the client for evidence of A. bradycardia and hypotension. B. restlessness and hypoxia. C. peripheral edema and exertional dyspnea. D. hypothermia and ventricular dysrhythmias.

C. peripheral edema and exertional dyspnea.

A 53 y/o client who recently had a right pneumonectomy for lung cancer is admitted with dyspnea and fever. The nurse should: A. Instruct the client to maintain bedrest with bathroom privileges b. Position the client for postural drainage C. Place the client on the left side D. Provide education on deep breathing exercises

D. Provide education on deep breathing exercises